Organization
CMSESSENTIALCAREPROVIDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DELANTA LENEE CLARK (CAREGIVER)
(702) 513-4162
Entity
Organization
Contact information
Practice address
3515 N 18TH ST, OMAHA, NE 68110-1820
(702) 513-4162
Mailing address
3515 N 18TH ST, OMAHA, NE 68110-1820
(702) 513-4162
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
Primary
—
—
Other
Enumeration date
03/13/2026
Last updated
03/13/2026
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